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目的:研究急性呼吸窘迫综合征(ARDS)患者机械通气时内源性呼气末正压的发生率,探讨内源性呼气末正压的临床意义。方法:前瞻性应用德尔格Evita 4和Evita 2 dura呼吸机测定34例ARDS患者机械通气时内源性呼气末正压。结果:34例急性呼吸窘迫综合症患者机械通气时内源性呼气末正压发生率为100%,内源性呼气末正压范围为2～15cm H_2O,平均为5.41±2.12cm H_2O,随着病情好转,内源性呼气末正压下降。结论:ARDS患者机械通气时普遍存在内源性呼气末正压,故此对ARDS患者机械通气时随时要注意内源性呼气末正压,减少气压伤的发生率。
Objective: To study the incidence of endogenous positive end-expiratory pressure during mechanical ventilation in patients with acute respiratory distress syndrome (ARDS) and to explore the clinical significance of endogenous positive end-expiratory pressure. Methods: Prospective endodorial positive end expiratory pressure was measured in 34 patients with ARDS undergoing mechanical ventilation using the Dräger Evita 4 and Evita 2 dura ventilator. Results: The incidence of endogenous positive end-expiratory pressure in 34 patients with acute respiratory distress syndrome was 100%, the positive end-expiratory pressure ranged from 2 to 15 cm H 2 O, with an average of 5.41 ± 2.12 cm H 2 O, As the condition improved, endogenous positive expiratory pressure decreased. Conclusions: Endogenous positive end expiratory pressure (ARP) is common in patients with ARDS. Therefore, it is necessary to pay attention to endogenous positive end expiratory pressure during mechanical ventilation in ARDS patients to reduce the incidence of barotrauma.